Health
Opioids have claimed the lives of over 800,000 Americans between 1999 and 2023, becoming a substantial national public health issue. In 2023, fentanyl — a synthetic opioid up to 50 times stronger than heroin— accounted for 80.0% of opioid-related overdoses, according to provisional CDC data.[1]
Fentanyl deaths have risen over the last decade, with nearly 24 times more deaths in 2022 than 2013, and approximately 73,838 deaths in 2022 alone.
Location, race, and age data on fentanyl deaths reveals an underlying disparity in who is most affected by the opioid crisis.
In 2022, West Virginia had the highest rate of age-adjusted fentanyl overdoses of any state, at 67 deaths per 100,000 people, 42.3% higher than Delaware, with the next highest rate of 47.1.
South Dakota had the lowest rate of fentanyl overdoses, with 4.6 deaths per 100,000 residents.
West Virginia was home to seven of the 10 counties with the highest fentanyl overdose rates, based on 2022 county-level CDC data.
2022’s fentanyl overdose rates varied widely by race, with Black people or African Americans experiencing rates at 33.7 deaths per 100,000 people — nearly 50% higher than the national average. Despite representing 13.6% of the US population, Black Americans made up 21.2% of fentanyl deaths.
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Indigenous people had the second highest overdose rate, at 26.7 deaths per 100,000 people, while white Americans were third at 23.0 deaths per 100,000 people.
Asian Americans had rates below the national average, at 3.0 deaths per 100,000 people — making up 0.9% of fentanyl deaths while comprising 6.3% of the population.
In 2022, adults ages 35 through 44 accounted for 20,266 fentanyl overdose deaths, or 27.4% of fentanyl deaths that year, and were 13.1% of the US population.
Adults between 25 and 34 accounted for 18,328 fentanyl overdose deaths, or 24.8% of total deaths, but were 13.7% of the population. Together, these two age groups accounted for over half of all fentanyl deaths.
Overdose deaths from fentanyl and other synthetic opioids have increased over the last decade to become the nation's most common cause of overdose as of 2016.
In 1999, fentanyl overdoses resulted in 730 deaths. This figure rose to 2,946 in 2009 and 36,359 in 2019. The CDC recorded approximately 73,838 fentanyl overdose deaths in 2022, or nearly 102 times the deaths in 1999.
Since 2017, fentanyl has comprised more than 50.0% of opioid overdose deaths, reaching 90.3% in 2022.
The reasons why fentanyl usage is growing are multifaceted; however, a key factor is the flow of fentanyl and fentanyl ingredients internationally from countries such as Mexico, China, and India, according to the US Drug Enforcement Administration.
The government has passed legislation and boosted funding for prevention and treatment initiatives in order to combat the fentanyl crisis.
Laws such as the 2016 Comprehensive Addiction and Recovery Act, the 21st Century Cures Act, and the SUPPORT Act are intended to enhance national capacity for opioid misuse prevention, treatment, and recovery. They have also introduced measures against overprescribing.
Additionally, the Fentanyl Sanctions Act and the Blocking Deadly Fentanyl Imports Act focus on curbing the supply and trafficking of illicit opioids. To directly combat overdose risks, Congress has increased funding for the distribution of naloxone and support for syringe services programs.
These efforts aim to reduce both the demand and supply of opioids, addressing the crisis through legislative action, funding increases, and international cooperation.
Data on fentanyl deaths comes from the CDC Wonder database tracking overdose-related deaths up to May 2024. Additional data on fentanyl statistics and information comes from the National Institute on Drug Abuse and the Drug Enforcement Administration.
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Throughout this article, we refer to fentanyl deaths in place of the CDC descriptor of “Other synthetic narcotics,” which is found under code T40.4 in the CDC Wonder database. We make this judgement since a majority of overdose deaths in this category are attributed to fentanyl by the National Institute on Drug Abuse.
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